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Hiok Hong Chan, Tina Wong, Ecosse Lamoureux, Shamira Perera; Acceptance, Attitudes and Beliefs Of Singaporean Chinese Towards Subconjunctival, Intracameral and Punctal Plug Methods of Sustained Glaucoma Drug Delivery Systems. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4413.
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To investigate the acceptance, attitudes and beliefs towards the subconjunctival, intracameral and punctal plug methods of sustained drug delivery systems in glaucoma patients. These sustained drug delivery systems may improve adherence and provide better outcomes compared to glaucoma eye drops.
A cross-sectional study involving 250 patients recruited from outpatient glaucoma clinics for an interviewer-administered survey. Beliefs towards medicines, eye drops, illness perception, medication adherence and health literacy were assessed via validated questionnaires. After receiving standard education of the 3 sustained drug delivery systems, acceptance and attitudes towards them were determined via a newly designed questionnaire.
The 250 patients enrolled had a mean (SD) age of 64.4 (10.2) and 139 (55.6%) were males. 174 (69.6%) of the patients received healthcare subsidies. 194 (77.6%) had Primary Open Angle Glaucoma with a mean duration since diagnosis of 4.64 years (5.39). 204 (81.6%) patients had bilaterally affected glaucomatous eyes and 174 (69.6%) had their worse eye with at least stage 2 glaucoma (Glaucoma Severity Staging). Majority accepted the 3 sustained drug delivery systems - via subconjunctival (61.6%), intracameral (57.2%) and punctal plug (63.2%) methods. Amongst those who accepted, 78.6%, 79.1% and 78.5% were willing to pay at least an equal cost as their current eye drops for the subconjunctival, intracameral and punctal plug methods, respectively. Predictive factors of acceptance include: male gender (p= 0.009, 0.014, 0.046, respectively), patients not on healthcare subsidies (p= 0.032, 0.002, 0.016, respectively) and bilaterally affected glaucomatous eyes (p= 0.006, 0.013, 0.004, respectively). 120 (48.0%) patients ranked punctal plug placement as the top choice for sustained drug delivery compared to subconjunctival (76, 30.4%) and intracameral (54, 21.6%) methods.
Although the subconjunctival, intracameral and punctal plug methods of sustained drug delivery are acceptable alternatives to glaucoma eye drops, the punctal plug placement was the preferred method for sustained drug delivery. The male gender, patients not on healthcare subsidies and with bilaterally affected glaucomatous eyes were the subgroups most receptive to these alternatives.
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